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Pollution and Autoimmunity (7.12.2024)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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PNAS & Nature Insights into Lupus Pathogenesis
Two prominent medical journals this week published new insights into the pathogenesis of systemic lupus erythematosus (SLE), with both inidicating promient roles for T cells in what is a classically viewed as a humoral (B cell) disorder.
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Ultraprocessed Foods Increase Lupus Risk
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MedPage Today
Among women followed for upwards of 25 years, those who ate relatively large amounts of "ultraprocessed" foods -- such as soft drinks, frozen pizzas, and mass-produced baked goods -- developed systemic lupus erythematosus at more than 50% greater rates than those with relatively low consumption, a new analysis of Nurses' Health Study data showed.
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Progress in SLE with new mRNA CAR-T cell Trial
Cartesian Therapeutics, has announced their first-in-class mRNA-engineered chimeric antigen receptor T-cell therapy (mRNA CAR-T) therapy has been given to the first systematic lupus erythematosus (SLE). patient in a Phase 2 open-label clinical trial.
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Full read, comprehensive review of NLRP3 inflammasome & its role in inate immunity (eg, infections), but also lifestyle (obesity, diabetes, NAFLD, heart/lung disease, periodontitis) and autoimmune diseases https://t.co/rCk9ncEsGA https://t.co/qc9eSIAVYe
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European Research Council has awarded a Proof of Concept Grant to Institute of Bioengineering of Catalonia and their OrthoBots project, to study the treatment of joint diseases using nanorobots to deliver nanoparticle based therapy to synovial tissues https://t.co/JmYQ1727rf https://t.co/k5uZoSwJPo
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ICYMI: Community-Acquired Pneumonia (CAP)
https://t.co/geb8y2AK26 https://t.co/cB3y5vQoz1
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Progress in SLE with new mRNA CAR-T cell Trial
Cartesian Therapeutics, has announced their first-in-class mRNA CAR-T therapy has been given to the first SLE. patient in a Phase 2 open-label clinical trial.
https://t.co/7SYNtjIn9F https://t.co/a5LJn8QLT3
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Urticarial vasculitis - rare autoimmune dz w/ persistent edematous papules & plaques lasting >24 hrs, w/ systemic Sxs (joint pain, fever). Long-lasting skin lesions tend to leave a bruiselike look. Requires Bx show leukocytoclasticl vasculitis https://t.co/cFWrntrlMw https://t.co/JPkh5FVNo3
Links:
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ICYMI: 2022 EULAR Recommendations on Screening & Prophylaxis for Opportunistic Infections
https://t.co/eHn2o2pFFR https://t.co/8S1fzl4AaJ
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MTX was tapered or D/C in 30% of RA pts w/in 2 yrs of b/tsDMARD Rx. Of 889 pts, MTX (19 mg/wk) tapered in 13.8% & D/C 16.5% (planned taper(37%); pt decision (27.2%). In 582 (66%) MTX unchanged, 4.25 increased MTX after b/tsDMARD initiation https://t.co/yc8exMbeD1 https://t.co/b3L3Fha7xU
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Bimekizumab (dual-IL-17A/F inhib), may prevent uveitis in patients with axSpA. In phase 3 RCTs (MOBILE 1 & 2) double-blind period, uveitis seen in 0.6% on BKZ vs 4.6% on PBO (p=0.001). In pts w/ hx uveitis, again lower w/ BKZ (6.2/100 PYs vs 70.4/100 PYs) https://t.co/v0wMK45chz https://t.co/CVPdg1k41V
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PMR - a Risk Factor for Recalcitrant Giant Cell Arteritis?
Despite the clinical similarities and treatment differences between giant cell arteritis (GCA polymyalgia rheumatica (PMR), confusion exists regarding the impact of overlapping disorders.
https://t.co/Slnq68YQgh https://t.co/nCYswGmlCk
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Cost-Effectiveness of Biosimilars vs Leflunomide
An economic evaluation of 25 099 rheumatoid arthritis patients found that treatment with biosimilar DMARDs were cost-effective compared with the conventional DMARD, leflunomide.
https://t.co/lWJB1VL1CL https://t.co/lzra8suVqs
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IV zoledronic acid (ZA) does not prevent future knee replacement (TKR) in symptomatic knee OA without severe joint space narrowing (JSN). In 222 Knee OA pts, after 7 yrs F/U, ZA had more TKR (39% vs 30%; HR 4.2' 1.2-14.7) https://t.co/2cGeqz2Rwu https://t.co/1UiODwQiK6
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ICYMI: Can Mycophenolate be Stopped in Stable SLE?
https://t.co/WJv2CajgW9 https://t.co/AU8X5bVSJQ
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CHANCE-3 DBR-PCT of 8343 adults (>40yrs) w/ CVA or TIA & hsCRP ≥2 mg/L showed that colchicine (0.5mg) x 90d did not prevent (6.3% vs 6.5%; HR 0.98; 0.83 to 1.16) subsequent stroke within 90 days compared with placebo https://t.co/APiMYVkBTV https://t.co/VgFiCKfMqB
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ICYMI: Dead Words Eulogy
https://t.co/kmgWJDMigE https://t.co/raZvkGW4vv
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Paradoxical psoriasis w/ IL-17 inhib? Lit review 35 (SpA) pts, presenting as palmoplantar pustular and plaque PsO; median 11 weeks after IL-17i. one-third continued IL-17i w/ mostly topical Rx; 2/3 D/C IL-17i, switching to other biologic w/ good outcomes https://t.co/q2xqQyiM3b https://t.co/6hSE6NLHWw
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5 yr results of 150 difficult-to-treat RA pts - D2T RA resolved in 45%, persisted in 50%, & 5% died. Resolved D2T RA was signif younger, had more Rx changes, & more IL-6i use. Mortality predicted by comorbidity index, steroid escalation (OR 3.50; & 32) https://t.co/cIUNcQ0r3F https://t.co/rNZaWu3Ocd
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